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Modern State of Fertility 2019

Space Welcome to the inaugural Modern State of Fertility, the survey where hundreds of women share what they know, what they wish they knew, and how their outlook on fertility is shifting. Modern Fertility, a women’s health company offering a fertility hormone test you can take at home, and Glamour, teamed up on this report to push fertility research forward for Infertility Awareness Week. It’s time we understood the information—and the gaps—so we Modern women can be our own best health advocates.

Our top takeaways

1. It takes two to tango—but women feel they’re the only ones bearing the burden

Insight: Although fertility is often misconstrued as “a woman’s problem”, male factors contribute to infertility. A much-cited study found that around 50% of all cases of infertility are due to female factors alone, 20-30% are due to male factors alone, and the remaining 20-30% are due to a combination of male and female factors.

People are far less aware of the impact of age and weight on men’s fertility vs. women’s fertility.
2. Even age, one of the most commonly used indicators of fertility, is still misunderstood

Insight: Few women understand how much aging negatively impacts natural conception. For women, fertility declines significantly after around age 35, and for men, fertility declines significantly after age 45.

Only 2% of women have a comprehensive understanding of how age affects fertility for men and women.
3. In-vitro fertilization (IVF): it's not so straightforward

Insight: Most women think that IVF is a highly successful procedure with few complications. The reality is that IVF is not always successful, usually requires multiple tries, and can involve risks to mothers and babies.

More than 80% of women don’t fully understand the risks and outcomes of IVF
4. It’s 2019. We need more than “just wait and see.” We need education.

Insight: 57% of women would like information from a fertility specialist, but there are only about 500 infertility clinics nationwide.

87% of women would alter their life plan if they knew they had fewer eggs than average for their age

“I had twins with the help of IVF. When people talk to me about them and ask questions, I openly tell them how they were conceived. If they are judging me for it, then I haven’t noticed because frankly I don’t care.”

Extended survey results

Let’s get the information straight and uncover what women are thinking and feeling about fertility treatments, stigmas, information sources, and more.

General Fertility Knowledge

Insight: 1 in 6 heterosexual couples are infertile.

Only 61% realize that 1 in 6 heterosexual couples are infertile.

Age knowledge

Today, 2% of women have a comprehensive understanding of age’s impact on fertility (meaning, they scored 100%), and 47% answered correctly to about half of the survey questions about age.

Insight: Female fertility significantly declines between the ages of 35 and 39.

86% of women are aware that female fertility significantly declines between the ages of 35 and 39.

Male fertility significantly declines between the ages of 45 and 49.

62% of women are aware that female fertility significantly declines between the ages of 45 and 49.

Insight: After age 35, a woman is more likely to have medical problems during pregnancy.

90% are aware that a woman is more likely to have medical problems during pregnancy after age 35.

Insight: Women who are transitioning into menopause have a lower chance of becoming pregnant.

57% know that women who are transitioning into menopause have a lower chance of becoming pregnant.

Insight: When a woman is over 35 years old, cesarean section (C-section) is more common.

56% know that a c-section is more common among women over age 35.

Insight: When a woman is over 35 years old, age is a better indicator of fertility than overall health.

77% know that when a woman is over 35 years old, age is a better indicator of fertility than overall health.

Insight: When a man is over 45 years old, there is a significant decline in the ability to impregnate his partner.

71% know that a man’s ability to impregnate his partner significantly declines after age 45

Insight: A man's age is an important factor in a couple's chances of becoming pregnant.

72% know that a man's age is an important factor in a couple's chances of becoming pregnant.

Hormones knowledge

Today, 57% of women have a comprehensive understanding of how hormones impact fertility.

Insight: A woman's hormone levels provide information about her fertility.

82% are aware that a woman's hormone levels provide information about her fertility.

Insight: The number of eggs a woman has in her ovaries decreases from birth to puberty.

80% know that the number of eggs a woman has in her ovaries decreases from birth to puberty.

Insight: Taking oral contraceptive pills does not "save" eggs.

82% know that taking oral contraceptive pills does not "save" eggs.

Risk Factors knowledge

Today, 57% of women have a comprehensive understanding of how hormones impact fertility.

Insight: Smoking has an impact on a woman's fertility.

96% are aware that smoking has an impact on a woman's fertility.

Insight: Smoking cigarettes or marijuana can reduce the quality of a man's sperm.

87% know that smoking cigarettes or marijuana can reduce the quality of a man's sperm.

Insight: A woman's weight affects her chances of conceiving.

90% know that a woman's weight affects her chances of conceiving.

Insight: A man's weight impacts his likelihood of impregnating his partner.

Only 53% are aware that a man's weight impacts his likelihood of impregnating his partner.

Insight: People who have had a sexually transmitted infection have an increased risk of reduced fertility.

73% know that people who’ve had an STI have an increased risk of reduced fertility.

Insight: Having an abortion does not reduce a woman's future fertility.

63% know that having an abortion does not reduce a woman's future fertility.

Insight: Taking hormonal birth control (for example, pill, patch, IUD) for more than five years does not reduce a woman's fertility.

58% know taking hormonal birth control for more than five years does not reduce a woman's fertility.

Hormone Blood Tests Knowledge

Only 8% of women have a comprehensive understanding of the importance of hormone blood tests for understanding fertility.

Insight: Hormone blood tests can be used to estimate the number of eggs a woman has in her ovaries.

Only 59% know hormone blood tests can estimate the number of eggs a woman has in her ovaries.

Insight: Hormone blood tests can be used to understand potential outcomes for egg-freezing and in-vitro fertilization.

Only 54% know hormone blood tests can inform potential outcomes for egg-freezing and IVF.

Insight: Hormone blood tests can detect if a woman has ovulated (meaning her ovaries have released an egg that month).

Only 51% know hormone blood tests can detect if a woman has ovulated (released an egg) that month.

Insight: Hormone blood tests can be used to estimate when a woman will reach menopause.

70% know hormone blood tests can be used to estimate when a woman will reach menopause.

Fertility Treatments Knowledge

Only 0.9% of women have a comprehensive understanding of IVF fertility treatments.

Insight: Most women or couples are not able to get pregnant after one IVF treatment.

79% know most women or couples are not able to get pregnant after one IVF treatment.

Insight: The total cost of one cycle of IVF treatment is more than $5,000 USD.

84% know that the total cost of one cycle of IVF treatment is more than $5,000 USD.

Insight: C-sections are more common after a woman undergoes IVF.

Only 12% realize c-sections are more common after a woman undergoes IVF.

Insight: the risk of delivering a baby preterm is higher after IVF.

77% are aware that the risk of delivering a baby preterm is higher after IVF.

Insight: more than half of IVF cycles are unsuccessful when women try to use their own eggs. (Source: SART 2017)

89% know that more than half of IVF cycles are unsuccessful when women try to use their own eggs.

“People who know little about my situation sometimes feel the need to tell me EXACTLY what to do about it. It is hard enough to be infertile without that unsolicited advice.”

Information Discrepency

If knowledge is power, then women are ready for it. (But we knew that).Women want more information, particularly about factors that decrease a person’s fertility, how their hormones impact their fertility, and hormone blood tests for women.

77% of women wish they know how their hormones impact their fertility

Information Channels

More women would like to receive fertility information from a specialist, but the numbers don’t add up: there are only about 2,000 reproductive endocrinologists (fertility specialists) nationwide.

Today, most women currently receive their information about fertility from a general healthcare provider and health-focused websites.

Where women currently get info on fertility
60% turn to their healthcare provider for info about fertility; 47% turn to health-focused websites.

Where women want to get info on fertility
57% wish they could speak with a specialist healthcare provider about their fertility

Emotions

Feeling interested, anxious and stressed about your fertility? Turns out, you’re not alone.

“Interested” and “Anxious” are two most common feelings people feel about fertility.

“Most people assume I don't want to have children and have considered me selfish. We are currently going through round 3 of IVF.”

Insurance and Fertility

Women think it is important for their insurance to cover annual fertility testing and infertility treatments.

The majority of women would choose an employer that provides these benefits over one that does not.

78% of women say its important to them that insurance covers the cost of fertility treatments

Infertility Stigma

Fertility stigmas prevail. Women believe that stigmas associated with fertility are worse for them than they are for men, except for when it comes to looking after children.

40% think people think less of women who are infertile vs 24% who’d think less of men who are infertile

“Most were asking why we didn't have children yet, or saying I better have a baby soon before I'm too old. Maybe if I had shared what I was going through, it would have made the situation more bearable.”

Home Fertility Tests

While stigmas reflect long-held negative sentiments, women generally have positive attitudes and perceptions when it comes to innovations in fertility care testing and treatment options.

84% think a home fertility test would be helpful

I had a guy come to our five bedroom house with a basketball court to look at a bee problem we were having. He had his young son along, who immediately and repeatedly asked where our kids were and why I didn’t have any. The bee guy was clearly embarrassed.

Intent to Take Action

Give women information impacting their bodies and futures, and more often than not, they’ll take charge and make changes.

If women knew that they had fewer eggs than average for their age, what would they do?

87% would take some sort of action if they found out they had fewer eggs than average for their age

Methodology

This research was conducted by Modern Fertility’s research team and was approved by an Institutional Review Board (IRB), ensuring the highest ethical standards for human research. This study was conducted as a cross-sectional survey to discover what women currently understand about fertility. A cross-sectional survey means that we gathered the data at a single point in time and did not attempt to change or alter their beliefs in any way when gathering the data.

So, what can - and can’t - this type of study tell us? A cross-sectional survey is a great way to learn about the number of women who hold certain beliefs and uncover the correlational relationships between those beliefs. This type of study can’t tell us anything about causation.

Importantly, we wanted to make sure we conducted this study in the most accurate and scientifically sound way possible. Modern Fertility’s research team, comprised of PhD researchers and fertility and reproductive medical specialists, is committed to using the highest standards in academic research. We obtained Institutional Review Board (IRB) approval of our study protocol, which ensures we met ethical standards in human research. We also used reliable and validated measures and statistical analyses.

Demographics

The women ranged in age from 18 to 59 (M = 34.11, SD = 6.64).

The majority of the women indicated that they are hetersexual/straight (95.1%); 4.6% indicated they are bi-sexual, and 0.3% indicated they are gay/lesbian.

Approximately 1/3 of the women (33%) indicated they had infertility problems.

Geographic Region

Northeast

19.0%

South

30.9%

Midwest

18.3%

West

29.7%

Pacific

0%

Did not indicate

1.5%

Education

Less than high school

0.3%

High school graduate

1.8%

Some college

11.9%

2 year degree

4.3%

4 year degree

41.6%

Attended and/or completed graduate school

40.1%

Racial/Ethnic Background

Note: could select more than one

American Indian or Alaskan

0.6%

Asian

5.5%

Black or African American

8.6%

Native Hawaiian or Other Pacific Islander

0.9%

White

75.84%

Hispanic or Latino

13.46%

Other

1.8%

Prefer not to say

0.9%